Drug Side Effects (Cardio) Flashcards
Ivabradine.
Arrhythmias (AF, bradycardia, AV block), hypotension, plasma conc increased when co-administered with verapamil.
B-agonists.
Tissue necrosis due to peripheral vasoconstriction, acute pulmonary oedema, tremor, arrhythmias (tachycardia esp), chest pain/angina, anxiety/panic attacks, adrenaline also causes bronchodilation.
B-blockers.
Fatigue/malaise, cold peripheries (with maybe paraesthesia [pins and needles]), peripheral vasoconstriction, heart failure (when sympathetic drive needed to maintain CO), bradycardia, AV block, hypoglycaemia (cardioselective have less risk).
Muscarinic antagonists (atropine).
Dilation of pupils, dry mouth, transient tachycardia, reduced bronchial secretions.
Calcium sensitiser (levosimendan).
Arrhythmias, hypokalaemia.
Digoxin.
Blurry or yellow vision, AV block, thrombocytopenia, arrhythmias (SV origin particularly).
Class Ia antiarrhythmics.
Blurred vision, dry mouth, constipation, urinary retention.
Class Ib antiarrhythmics.
Local anaesthetic, drowsiness and confusion, hepatitis and liver failure.
Class Ic antiarrhythmics.
Sudden cardiac death associated with VF after MI.
Class III antiarrhythmics.
Hypokalaemia (may precipitate torsades de pointes), phlebitis if given in peripheral vein, photosensitive rash, hypo/hyperthyroidism, pulmonary fibrosis, long QT.
Adenosine.
Chest pain, dyspnoea, dizziness, nausea, AV block, sinus pause, bradycardia/asystole.
Organic nitrates.
Throbbing headache (initially), hypotension esp postural, tolerance common for prolonged ISMN use.
ACEIs.
Hypotension (first dose esp), dry cough, hyperkalaemia, renal dysfunction, angioneurotic oedema, peripheral oedema.
ARBs.
Same as ACEIs but without angioneurotic oedema.
Calcium channel blockers (dihydropyridines).
Peripheral oedema, postural hypotension, thrombocytopenia.
Verapamil.
Constipation, AV block, bradycardia/asystole, peripheral oedema, CCF with pulmonary oedema, increased risk of myopathy when used with atorvastatin and simvastatin. Increases plasma conc of ivabradine, digoxin and dabigatran.
Diltiazem.
AV block, peripheral oedema, bradycardia/SA block, increases plasma conc of digoxin and ivabradine.
A-blockers.
Hypotension (first dose and postural), peripheral oedema, headache (initially).
Potassium channel openers.
Rectal bleeding, hypotension, angioneurotic oedema, cutaneous dilation with flushing, reflex tachycardia at high doses.
Loop diuretics.
Hypokalaemia, electrolyte imbalance, postural and first dose hypotension, exacerbate diabetes, induced hypokalaemia can precipitate hepatic encephalopathy.
Thiazide diuretics and thiazide-like diuretics.
Hypokalaemia, electrolyte imbalance, postural and first dose hypotension, hypercalcaemia, impotence, gout and gouty arthritis, exacerbate diabetes, induced hypokalaemia can precipitate hepatic encephalopathy
Spironolactone.
Hyperkalaemia, gynaecomastia, electrolyte imbalance, hypertrichosis (excessive hair growth).
HMG CoA reductase inhibitors (statins).
Hyperglycaemia and diabetes mellitus, myalgia, myopathy, arthralgia, rhabdomyolysis, renal failure.
Fibrates.
Myalgia, myopathy, arthralgia, rhabdomyolysis, renal failure, hepatitis and liver failure (due to hepatotoxicity).
Bile acid binding resins.
GI discomfort, bad tasting mouth, deficiency of fat-soluble vitamins, coagulopathy due to vit K deficiency.
Cholesterol absorption inhibitors.
GI discomfort, hepatitis and liver failure, myalgia, myopathy, arthralgia.
Warfarin.
Haemorrhage, skin necrosis (protein C or S deficiency), (higher risk of haemorrhage in liver disease, high metabolic rate or drugs),
Heparin and LMWH.
Haemorrhage, osteoporosis, hyperkalaemia (due to hyperaldosteronism), hypersensitivity reactions, hepatin-induced thrombocytopenia, LMWH not suitable for patients with renal impairment.
DOACs.
Haemorrhage, thrombocytopenia.
Antiplatelets.
Haemorrhage, peptic ulcer, bronchospasm (asthma), GI disturbance (PPI usually given with aspirin).
Fibrinolytics.
Haemorrhage.
